Original Research

Quality of psychiatric referrals to secondary-level care

W Struwig, P J Pretorius
South African Journal of Psychiatry | Vol 15, No 2 | a207 | DOI: https://doi.org/10.4102/sajpsychiatry.v15i2.207 | © 2009 W Struwig, P J Pretorius | This work is licensed under CC Attribution 4.0
Submitted: 26 June 2009 | Published: 01 June 2009

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W Struwig,
P J Pretorius, Department of Psychiatry, Faculty of Health Sciences, University of the Free State, Bloemfontein

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Objectives. This study examined the quality of referrals to secondary-level outpatient psychiatric services rendered by the Department of Psychiatry, University of the Free State. Referral letters were evaluated according to specific quality criteria. Aspects that would enable secondary-level doctors to make informed decisions in terms of further management and need for special investigations were specifically considered.

Design. A descriptive study design was used, and convenience sampling included all referrals to the unit over a 6-month period (June - November 2007). All referral letters were screened according to a checklist designed for this study.

Setting. The study was undertaken at the Psychiatry Outpatient Department of the Pelonomi Provincial Hospital in Bloemfontein, which functions as a secondary-level referral centre for mental health in the southern Free State. Outcome measures. Descriptive statistics (percentages, means and standard deviations) were used to summarise results. Results. Two hundred and sixty-three referral letters were included in the study. Less than 20% of the referral letters included information on previous psychiatric consultations, current psychotropic medication, the outcome of physical examinations, and results of special investigations. Only 17 (6%) referral letters indicated a preliminary diagnosis according to an officially recognised classification system.

Conclusion. There was conclusive evidence that the quality of referrals to the Psychiatry Department was generally inadequate. A need for more effective referral strategies was identified.


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